文章基本信息

标题：Active Surveillance of Maternal Mortality in New York City
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作者：Daniel J. Pallin ; Vandana Sundaram ; Fabienne Laraque 等
期刊名称：American journal of public health
印刷版ISSN：0090-0036
出版年度：2002
卷号：92
期号：8
页码：1319-1322
语种：English
出版社：American Public Health Association
摘要：Objectives. This study examined the usefulness of computer-assisted active surveillance in identifying maternal deaths in New York City. Methods. Computerized searches of hospital discharge and autopsy record databases were conducted for maternal deaths occurring in 1997. Results. Active surveillance revealed 14 new maternal deaths not previously reported, an 88% increase. Nine of these deaths were found through the hospital discharge database search, 1 was found through the autopsy record search, and 4 were found in both searches. Overall maternal mortality ratios associated with active surveillance and routine surveillance were 24.3 and 13.0 deaths per 100 000 live births, respectively. Conclusions. Active surveillance of maternal mortality is useful in identifying new maternal deaths. Existing databases can be used relatively easily to augment routine surveillance of maternal mortality. Maternal mortality is an important measure of the health of nations and of communities and indicates disparities in health and access to health care. 1, 2 Routine public health surveillance of maternal mortality is passive and has been shown to result in undercounts of maternal mortality rates. 3– 10 The Centers for Disease Control and Prevention (CDC) and the American College of Obstetrics and Gynecology have called for use of active surveillance methods to improve identification of pregnancy-related deaths. 4 Identifying more cases may increase our ability to uncover new risk factors and opportunities for prevention. Vital record linkage, review of autopsy records, and searches of hospital discharge databases have been used to detect higher percentages of maternal deaths. 3, 5, 6, 11– 13 Vital record linkage, which links birth or abortion files to women’s death files, has been automated on an experimental basis, allowing a system of active surveillance that is relatively easy to use and has high sensitivity and specificity. 11 New York City and other reporting areas have sought to improve surveillance of maternal mortality by adding a check box to death certificates to indicate a recent pregnancy. 3 Because many maternal deaths occur during hospital admissions, the availability of hospital discharge databases raises the possibility of computerized active surveillance of maternal mortality. Our goal was to test the usefulness of a hospital discharge database and an autopsy record search as methods of active surveillance of maternal mortality in New York City for 1997.